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Endo II > Cleaning and Shaping > Flashcards

Cleaning and Shaping Flashcards

1
Q

What are the basic principles of shaping?

A
  1. A constantly tapering funnel from crown to WL
  2. Curves of canal respected w/o “transportation”
  3. Retention of the “apical constriction”
  4. Enlargement of the canal system to create clean white filings
  5. Adequate “deep space” for proper obturation
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2
Q

What are the 9 steps (following a proper access)?

A
  1. Scouting
  2. Patency
  3. Working Length
  4. Glide Path
  5. Shaping of coronal 1/3 of canal
    ONLY HAND FILES to this point
  6. Shaping of middle 1/3 of canal
  7. Perfecting Straight-Line-Access to mid root
  8. Shaping of apical 1/3 of canal
  9. Final Shaping Objective
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3
Q

What file do you use for scouting?

A

10 hand file

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4
Q

How do you perform scouting?

A

take a #10 hand file and gently perform watch winding motion (right and left rocking motion)

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5
Q

What is performed at the same time as scouting?

A

patency

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6
Q

When do you know the canal is patent?

A

10 file goes slightly beyond the canal exit (0.5mm) into the periodontal ligament

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7
Q

How do you find patency in clinic?

A

apex locator

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8
Q

How do you find patency in clinic?

A

measure the tooth before you mount it

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9
Q

Patency is maintained by…

A

Recapitulation (irrigating and revisiting patency after Wave One with the patency file #10 only the canal The Apex)

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10
Q

If it is tight resistance to apical advancement you probably have a…

A

small canal which must be enlarged carefully

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11
Q

If it is loose resistance to apical advancement you probably have a…

A

canal curvature and you must bend the terminal flute of your file

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12
Q

What do you do if you do if you cannot reach patency?

A

DON’T FORCE IT
- ask faculty for help

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13
Q

What does the single red line on the apex locator indicate?

A

patency

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14
Q

All shaping is done at the…

A

working length (1 mm short of canal exit)

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15
Q

The working length is __mm short of canal exit?

A

1 mm

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16
Q

What is the reference point for working length on anteriors?

A

Incisal edge

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17
Q

What is the reference point for working length on posteriors?

A

Cusp for which canal is named, flatten cusp when possible

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18
Q

How do you tell if canals converge or are simply 2 canals in close proximity?

A
  • Establish working length
    of “each canal” separately
  • Attempt to place 2 files to WL in
    each Canal @ same time
  • If both go to WL = 2 canals (Class III canals)
  • If one goes & the other is short – reverse the placement sequence. If still one is short = converging Class II canals
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19
Q

During the two file technique if both files go to the working length then…

A

2 canals (class III)

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20
Q

During the two file technique if one goes to working length and one is short then…

A

covering class II canals

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21
Q

What is the purpose of creating a smooth “glide path”

A
  • To smooth curves & make sure there are no canal obstructions
  • To create space for rotary instruments to be used safely without excessive torque requirements.
  • To relieve stress on tip of rotary file to minimize fracture
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22
Q

The glide path is created using…

A

hand files (pre-curved to match or slightly exceed the curvature of the canal)

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23
Q

What is the process to create a smooth “glide path”?

A
  • using hand files in a watch-wind entry follow by pull strokes directed in a circumferential manner to enlarge the canal to size #15 at the working length
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24
Q

The operator action is a ___________ motion when shaping the canals by thirds

A

light “pecking”

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25
Q

As the ________ action tends to push debris ahead of the file so stop action at 1/3 and 2/3 of the operation approaching the apex to clean the file and to irrigate thoroughly at these stages of shaping

A

Wave One

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26
Q

__________ following each active instrument (revisit patency 2-3 times during cleaning and shaping)

A

Irrigate

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27
Q

If a 10 K-file was very resistant to movement, use Wave One Gold ____ file

A

Small

28
Q

If a 10 K-file moves to length easily, is loose or very loose, use Wave One Gold ______ file

A

Primary

29
Q

If a 20 hand file or larger goes to length, use Wave One Gold _____ file

A

Large

30
Q

The Crown usually is about 10mm of total tooth length. The root is mentally divided into _______

A

thirds

31
Q

We will be shaping the canal _____ at a time

A

1/3

32
Q

How do you perfect straight-line-access to mid root?

A
  • Place a .25/.08 Vortex Orifice opener in the Pro-Mark motor and adjust the action to Vortex and leave the speed at 500 rpm.
  • Allow the 25/.08 to mill to the depth of mid root ONLY
33
Q

When do you perfect straight-line-access to mid root?

A

Following 2nd 1/3 (Wave One shaping)

34
Q

How do you shape the apical 1/3 of the canal?

A
  • Set the Wave One Gold file at the confirmed WL and reset the Pro-Mark motor to reciprocal action
    and guide it to advance to the WL.
  • Confirm patency & smooth glide path with #15 hand file & then irrigate and continue to WL with Wave One.
  • IRRIGATE
35
Q

What do you do after every time you use a file?

A

irrigate

36
Q

What file do you use to do the final shaping?

A

Vortex Blue Files for the final shaping and smoothing of the canal

37
Q

How do you use the vortex blue files?

A

Each Vortex Blue file should be
KEPT MOVING and go completely to WL on each of 10 strokes. They should be flexed while rotating & being drawn out to away from
increase the flare furca of the canal in an appropriate direction or toward the greater dimension of the canal.

38
Q

How do you know when the final shaping is done?

A

Shaping is complete when dentinal filings are on apical 1/3 of the instrument

39
Q

Small Roots about #_____ MAF

A

30-35

40
Q

Medium Roots about #_____ MAF

A

40-45

41
Q

Large Roots are #____ MAF or
more

A

45-50

42
Q

Teeth with moderate to severe curvature require ________ MAF avoid transportation of canal

A

smaller

43
Q

Younger teeth will have larger
canals & require _______ MAF to clean

A

larger

44
Q

What is the serial step-back method?

A

a method of producing a greater taper at the apcial control zone (used when the canal requires a larger diameter than the .45/.04 vortex blue file)

45
Q

What teeth do you use a small MAF (master apical file)?

A

Mand. Incisors, 2 canal Premolars, M. canals of Mand. molars, B. canals of Max. Molars

46
Q

What teeth do you use a medium MAF (master apical file)?

A

Palatal canals of Max. Molars, Single Distal canals of Mand. Molars

47
Q

What teeth do you use a large MAF (master apical file)?

A

Max. Anteriors, M/M Cuspids, Single canal M/M Premolars

48
Q

How can you tell the degree and location of curvature (mesial and distal)?

A

radiograph

49
Q

_______________ curves will NOT generally be seen on radiographs

A

Facial and lingual

50
Q

How can you see the facial and lingual curves on radiographs?

A

–Try angled radiographs (SLOB)
–Look for “bulls eye”radiograph (root tip turns to F or L)
–If your initial #10 SS scouting file bends (it follows the anatomy of the canal)

51
Q

How do you accidentally create ledges and blockages?

A

When we place a straight SS hand file in a curved canal

  • Tends to gouge (convex) wall of the and lean against the outside creating the a Ledge, which can be the first step to Blockage or Transportation
52
Q

If we keep Pushing & Grinding against a ledge on the file, we can eventually force it through the root to create a…

A

Perforation

53
Q

As our shaping proceeded to the larger sizes of SS hand files above #15 :

A

-Increase in Stiffness
-Decrease in Flexibility

54
Q

What is a zip?

A

Transportationof apex occurs within the root

55
Q

If the Zipoccurs the through apex to the exterior of the root. We have an…

A

apical strip perforation

56
Q

Transportation is one of the
MAIN REASONS that we selected
the current technique in which
hand files used are generally no
larger than…

A

15

57
Q

You are encountering a ledge
bend or curve; what do you do?

A
  • Do Not Force File: Instead STOP Irrigate, and Bend file at the Tip (approx. 2mm)
  • The most apical flutes of the file must be bent and rotated to track the inside wall of the canal.
58
Q

What is a strip-perforation?

A
  • Occurs when files used are either too large or too aggressively used for a small or thin walled canal
  • invagination on the distal aspect of the mesial root of mandibular molars
59
Q

When do strip-perforations usually occur?

A

Commonly the distal of the mesial root of lower molars, MF of upper molars, 2 canal max. PM

60
Q

What can happen if there is a severe curve in the canal – especially if the curve occurs in the apical 1/3 and a smooth glide path was not perfected and the operator tries to PUSH or Force the Wave One Gold file to WL?

A

Transportation

61
Q

What can happen if you allow the vortex blue file to rotate at or slightly short of the working length for more than a moment?

A

transportation

62
Q

KEEP THE VORTEX BLUE FILE __________ at or slightly short using a smooth in-out motion in the canal while flexing the walls

A

MOVING

63
Q

What does this show?

A

strip perforation

64
Q

What does this show?

A

transportation

65
Q

What does this show?

A

ledge creation

Endo II (2 decks)

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